Periodontics-Gum Disease Treatment
Periodontics involves the diagnosis, treatment and prevention of gum disease by a general dentist or a periodontist. A periodontist is a dentist who has had additional years of specialized training in periodontics at a post-doctoral educational program and is certified as such.
Periodontal Disease is caused by a bacterial infection of the gums, bone and ligaments that support the teeth and anchor them in the jaw. The bacteria are normal inhabitants of the mouth and form a film of dental plaque and calculus (tartar) which stick to the teeth. The bacteria produce poisonous toxins which stimulate the immune response to fight the infection. If the disease process is not stopped, the supporting structures of the teeth will continue to be destroyed. This eventually leads to tooth loss.
Periodontal disease can occur at any age. Over half of all people over the age of 18 have some form of the disease. After age 35, over 75% of all people are affected. Unfortunately, the disease process is usually asymptomatic and painless. The disease can be easily detected during regular dental examinations.
The most common type of periodontal disease are gingivitis and periodontitis.
Healthy Gums and Bone
Gums appear light pink and are sharply defined. Bone completely surrounds the roots of the teeth. Teeth are firmly anchored into the bone.
Gingivitis and Your Gums
Gingivitis is infection of the gingiva (gum tissue), and is the initial stage of the disease process. Gums become red, swollen and may bleed easily. Underlying bone levels are unaffected.
Periodontitis is classified as being Mild, Moderate or Severe, depending upon the amount of destruction to the gums, ligaments and bone that surround teeth. As the disease progresses, gums separate from the teeth and form gum pockets. These pockets get deeper as more underlying bone is destroyed. Gum pockets will collect increasing amounts of bacterial plaque and calculus (tartar) as the disease process worsens. Teeth will loosen as more bone is lost.
If you are suffering from symptoms of periodontal disease, you should schedule an appointment with Sunnyvale dentist Dr. Antonious. Contact Sunnyvale Dental Care office today!
The response of the gums and bone to dental plaque may be modified by one or more of the following factors:
- Poorly fitting dental restorations
- Crowded teeth, improper bite alignment
- Clenching or grinding of teeth
- Hormonal changes, including pregnancy, menstruation and menopause
- Systemic diseases, including blood disorders and diabetes
- Medications, including calcium channel blockers and anti-convulsants
Warning Signs of Periodontal Disease
- Bleeding gums
- Tenderness, swelling, red color
- Abscess ( pus oozing from the gums )
- Foul odor
- Loose teeth
Diagnosis of Periodontal Disease
Periodontal disease can be easily detected by a general dentist or periodontist during regular examinations. A periodontist is a dentist who specializes in the diagnosis, prevention and treatment of gum disease. A periodontal charting should be performed for all teeth. A periodontal probe, with ruled millimeter markings, is used to measure the depth of the space between the teeth and gums. Ideally, normal measurements range between 1 and 3 millimeters. Depths greater than this may signify the presence of periodontal pockets and associated gum disease. X-rays should be taken to see if bone damage has occurred as a result of the disease process.
Treatment of Periodontal Disease
The main goal of periodontal treatment is eradication of the disease process from the gums, ligaments and bones that surround the teeth, and restoration of health that can be predictably maintained in the future.Sunnyvale Dental Care clinic offers periodontal (gum) maintenance program that is tailored to every individual patient’s needs.
Initial treatment involves educating patients in the proper methods of effective, daily plaque removal and oral hygiene. This is a critical component of successful therapy.
Scaling and root planing are performed to clean the tooth structure and remove bacterial plaque and calculus deposits (the source of the infection) from the gum pockets. This may be the only treatment necessary in cases of gingivitis and very mild periodontitis.
In cases which demonstrate deeper gum pockets and underlying bone loss, it becomes necessary to eliminate the diseased gum pockets and bony destruction with osseous (bone) surgery. The gum is “flapped” and retracted away from the teeth to expose the underlying roots and bone deformities. The bone is contoured to approximate a normal physiologic profile, and the gum is sutured back to place. When the gum heals, normal probing depth is re-established between the gum and tooth (ideally 1-3mm). The attainment of minimal probing depth facilitates easy removal of plaque by patients at home and by hygienists during professional cleaning.
Sequence of Events During Osseous Surgery
In our Sunnyvale Care office, Dr. Antonious may recommend additional treatment modalities to treat periodontal disease and restore oral health.
These may include:
- Bone grafts for bone regeneration
- Gum grafts to treat gum recession and pathological root exposure
- Cosmetic plastic surgery of the gums to improve appearance
- Fabrication of night guards for bruxism ( tooth grinding )
- Splinting or bonding teeth together for increased strength and stability
- Orthodontics ( braces ) to straighten and realign teeth
- Removal of diseased roots on some types of molars
- Use of medications such as antibiotics, fluoride and antimicrobial rinses
Once the active phase of treatment is complete and health has been restored, it is extremely important that patients be seen at our Sunnyvale Dental Care office for routine dental and periodontal cleaning on a regular basis. This regimen, along with diligent home care and oral hygiene, will give the best chance for preventing recurrence of disease and maintaining long term periodontal health.
Dr. Antonious believes that convenience goes beyond just location. “Dentist near me” should never be the only determining factor in choosing the best local dentist. Best quality of dental work and service are and always will be second to none. Our periodontal services is a prime example of that. Our periodontal dental services have been well reviewed and appreciated by many of our local dental patients as demonstrated by their tiptop reviews on YouTube, Yelp, Google and Facebook. Schedule your appointment today at your local Sunnyvale Dental Care, where affordable prices meet quality periodontal dental services.
City of Sunnyvale extends over 22.69 square miles and has 5 zip codes. All Zip codes including 94085, 94086, 94087, 94088 and 94089 are close to Sunnyvale Dental Care’s convenient location, which makes it convenient for patients who live in these zip codes to benefit from our dental services which include gum therapy and periodontal services.
Sunnyvale has special arrangements with specific insurance companies to save their PPO preferred policy holders on their dental treatment cost. They arranged a special PPO fee schedule to secure these savings. These companies include: Guardian, Avesis, Assurant, Anthem BlueCross, Cigna, DenteMax, Geha Connection, Aetna, HealthNet, Humana, MetLife, Principal, United HealthCare, First Dental Health, Ameritas, Maverest, Dentegra, and Dental Benefit Providers. Dr. Antonious has been a premier provider with Delta Dental since 1995.
Learn more when you visit Sunnyvale Dental Care practice. Call Sunnyvale Dentist Dr. Antonious at 408-720-0900 to schedule a consultation today!
Gum Disease (Gingivitis and Periodontitis) FAQs
How can I tell if I have gingivitis or periodontitis (gum disease)?
Four out of five people have periodontal (gum) disease and don’t know it! Most people are not aware of it because the disease is usually painless in the early stages. Unlike tooth decay, which often causes discomfort, it is possible to have periodontal disease without noticeable symptoms. Having regular dental check-ups and periodontal examinations at Sunnyvale Dental Care are very important and will help detect if periodontal problems exist.
Periodontal disease begins when plaque, a sticky, colorless, film of bacteria, food debris, and saliva, is left on the teeth and gums. The bacteria produce toxins (acids) that inflame the gums and slowly destroy the bone. Brushing and flossing regularly and properly will ensure that plaque is not left behind to do its damage.
Other than poor oral hygiene, there are several other factors that may increase the risk of developing periodontal disease:
- Smoking or chewing tobacco – Tobacco users are more likely than nonusers to form plaque and tartar on their teeth.
- Certain tooth or appliance conditions – Bridges that no longer fit properly, crowded teeth, or defective fillings that may trap plaque and bacteria.
- Many medications – Steroids, cancer therapy drugs, blood pressure meds, oral contraceptives. Some medications have side affects that reduce saliva
- Pregnancy, oral contraceptives, and puberty – Can cause changes in hormone levels, causing gum tissue to become more sensitive to bacteria toxins.
- Systemic diseases – Diabetes, blood cell disorders, HIV / AIDS, etc.
- Genetics may play role – Some patients may be predisposed to a more aggressive type of periodontitis. Patients with a family history of tooth loss should pay particular attention to their gums.
Sunnyvale dentist Dr. Antonious will discuss with you what he believes to be the underline reason and risk factors of your gum disease and what your best treatment option is.
Signs and Symptoms of Periodontal Disease
- Red and puffy gums – Gums should never be red or swollen.
- Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss.
- Persistent bad breath – Caused by bacteria in the mouth.
- New spacing between teeth – Caused by bone loss.
- Loose teeth – Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).
- Pus around the teeth and gums – Sign that there is an infection present.
- Receding gums – Loss of gum around a tooth.
- Tenderness or Discomfort – Plaque, calculus, and bacteria irritate the gums and teeth.
Good oral hygiene, a balanced diet, and regular dental visits at Sunnyvale Dental Care can help reduce your risk of developing periodontal disease.
If periodontal disease is such a problem, why doesn’t it hurt?
This is, unfortunately, a very good question. Periodontal problems can become quite serious and extremely advanced without any pain whatsoever. That is why it is so important to be attentive to the warning signs – bleeding gums when brushing and flossing, swollen gums, receded gums, teeth changing position, pus or swelling around gums – to name a few.
Is gum surgery essential if I have periodontal (gum) disease?
Sunnyvale dentist Dr. Antonious has found, many times, surgery is not necessary following a conservative course of periodontal treatment. This type of care typically includes a series of nonsurgical gum treatments. Even when surgery is required, it often is needed only in a few areas of the mouth and results can be greatly enhanced by nonsurgical preparation.
Gum Surgery Post-Op Instructions
Refrain from eating for at least 2 hours and until the anesthesia has worn off.
Diet: Do not eat for about 3 hours following the surgery. Then, a soft or liquid diet, including warm soup or instant breakfast, is advised for the next 2-3 days. Avoid alcohol, carbonated drinks, and hard, brittle foods such as tortilla chips that can injure the surgical site. Drinking plenty of fluids and eating a well balanced diet is important to your recovery.
Medications: Moderate discomfort may begin as the anesthesia wears off. A non-aspirin analgesic may be recommended to relieve any tenderness or discomfort, and may be taken within the first hour after surgery. It is important to take the prescribed antibiotic as it will aid in the healing process. If you have a reaction to a medication such as nausea, or skin rash, stop taking it immediately and call our office.
Bleeding Control: Slight bleeding or oozing after the surgery is normal and may occur at intervals for the first 24-48 hours. Forceful rinsing or excessive spitting can disrupt clotting, so do not rinse for at least 4 hours. If bleeding does persist:
- Apply a moistened gauze pad, or tea bag, with moderate pressure to the bleeding site for 20 minutes. Repeat, if necessary.
- Stay calm and quiet; lie down with the head elevated on 2-3 pillows.
- If the bleeding persists do not hesitate to call our office.
Swelling: Slight swelling is a common response in the healing process. To minimize excessive swelling, place an ice bag or a cold, moist compress over the involved site for 10-20 minute intervals. Repeat this several times as needed over the next 48 hours. If the swelling increases or discomfort develops, again, call our office.
Oral Hygiene: It is extremely important to keep your teeth and gums clean following surgery. Not only will this will help to achieve a better result, but the tissues will heal faster. Brush your teeth very lightly the first night. Then begin flossing the next day, allowing the floss to very gently touch the gums of the surgical area. Do not force the floss vigorously between the tooth and the gums as this will prevent the new attachment from developing normally. Also, refrain from using any irrigation devices such as the Water Pik. After brushing and flossing, apply chlorhexidine gluconate (Peridex), if prescribed, with a cotton swab first by dabbing the area lightly, and then gently swishing a capful in the mouth for 30 seconds. Avoid using any strong mouthwashes that contain alcohol. Chloraseptic and Cepastat are good ones to use.
No Smoking: Do not smoke for at least 48 hours. Smoking can seriously delay the healing process. If you have any questions or problems, please call our office.
Scaling & Root Planing Post-operative Instructions
Scaling and root planing therapy is a procedure that involves removing bacterial plaque and tartar from the root surface below the gum line with instruments and ultrasonics. It may also require removal of diseased tissue within the pocket with a laser. The goal of this treatment is to allow reattachment of the gums to the clean root surface and to shrink the periodontal pockets to levels that can be maintained by daily flossing and brushing. The following guidelines have been prepared for you in order to maximize healing and minimize any discomfort.
Refrain from eating for at least 2 hours and until the anesthesia has worn off.
Things to Avoid for the first 24 hours:
- Vigorous physical exercise, but you may return to work
- Drinking through a straw or sucking motions.
- Do not smoke. It’s better to refrain for 48 hours.
- Drinking alcoholic beverages will retard the healing process.
- Foods that are extreme in temperature or spicy.
- Avoid using any strong mouthwashes that contain alcohol.
Things to Do:
- You may take a non-aspirin analgesic to relieve any tenderness or discomfort, such as ibuprofen (Advil) or acetaminophen (Tylenol).
- Eat a well balanced soft diet for today. You may chew on the opposite side of the treated area until it is comfortable to chew normally.
- Rinse with a warm salt water rinse, a teaspoon in an 8 oz. glass of water, 3 times a day.
- Brush your teeth very lightly in the treated area the first night. Then begin flossing lightly as well the next day, gradually increasing to normal force by the week’s end.
- After flossing and brushing, rinse with chlorhexidine gluconate (Peridex), if it was prescribed, for at least 60 seconds. Do this at least twice daily. Chloraseptic and Cepastat are recommended mouthwashes.
- Several days after treatment your gums should begin to appear pinker, less swollen, and will bleed less when you floss. These are signs of healing and improving periodontal health. If you have any questions or problems, please call our office.